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HomeMy WebLinkAboutBuilding Permit # 7/28/2015 BUILDING PERMIT TOWN OF NTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received �yp°agrenHrP" .�,� sS�CHUS�R Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION ;: f �ki %, /� �, Prmt RRC7PERTY OWNER %',,,,,,,� ���, r ,�...'/ i i% MAP, ,,,,,, ,.,.:PARCEL :,' < ,, ', ZONINGDISTRICT H�stortcDistr�ct yes. no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic' o Well ❑ Floodplajn ❑Wetlands E! Watershed District ❑Water/Sewer ` DESCRIPTION OF WORK TO BE PERFORMED: dentification- Please ype or Print Clearly OWNER: Name: I' of i- a � Phone: ) �-7Z`- Address: Contractor, Name: 'Phone:,, . Address':' ' 41r i r ,Super�nsors Construction i Hayne Irnprouement„License Exp. Date.; ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT;$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $_ „tea FEE: $ y Check No.: GO, Receipt Na.: NOTE: Persons contNactang with untie isterontractors do not have access to the guaranty fun 'Signature of Agent/Owner - Si nature of contracto Anh ttORTH fown of 2 e nd0ver ® .:�.. `5 26 N j"V O LAKE h ver, as til 02 ?�15 T cocKicKewic.c �1• h R-ATE D P '�C> U BOARD OF HEALTH LDFood/Kitchen I P E M Septic System C % Z 0 LdL BUILDING INSPECTOR THIS CERTIFIES THAT ..................................................................... ...................................................... .1 ......................................... Foundation has permission to erect ........ ................. buildings on .... ..... .... a�1� v /� , !� Rough to be occupied as ... ......... .1� 4�...... .. ...1�!%1 .... Chimney provided that the person accepting this permit shall in every respe conform to the terms o the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final 1h I ITEXPIRES I ® ..HS PERM ELECTRICAL INSPECTOR UNLESS T RTS Rough Service ..... ... . ................................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. - Burner Street No. Smoke Det. TMK Remodeling 214 Sutton Hill Rd Contract CSL 105086 North Andover MA 01845 88—Mablin Window R2 HIC 165887 978 852-4491 RRP LR000106 www.tmkremodeling.com CONTRACTOR AGREEMENT THIS AGREEMENT made this 20\5 by and between Theodore Kelley dba TMK Remodeling, Construction Supervisor License# 105086,214 Sutton Hill Rd, North Andover MA 01845 hereinafter called the Contractor, and ffi hereinafter called the Homeowner. l 1 I zAl-�1 WITNESSETH,that the Contractor and the Homeowner for the consideration named herein agree as follows: ARTICLE 1.SCOPE OF THE WORK The Contractor shall perform all of the work described in the specifications entitled Exhibit A—Statement of Work, as annexed hereto as it pertains to work to be performed on property located at 88 Mablin St North Andover MA 01845. ARTICLE 2.TIME OF COMPLETION The work to be performed under this Contract shall be commenced on or before July 13, 2015 and shall be substantially completed on or before July 17,2015 ARTICLE 3.THE CONTRACT PRICE The Homeowner shall pay the Contractor for the labor and materials to be performed and supplied under the Contract the estimated sum of Three Thousand Seven Hundred Forty Dollars and No Cents ($3,740.00), subject to additions and deductions pursuant to authorized change orders. Contractor will furnish and install all building materials,fixtures and finish items unless noted otherwise. ARTICLE 4.PROGRESS PAYMENTS Payments of the Contract price shall be paid in the following manner from the Homeowner to the Contractor: 50% upon contract acceptance and signature;$1,870.00 50% upon completion and building inspection;$1,870.00 The contract cost for mutually agreed to change orders will be paid 50%at time of change order signature and 50% after completion and Homeowner sign-off. ARTICLE 5.GENERAL PROVISIONS 1. All work shall be completed in a workmanship like manner and in compliance with all building codes and other applicable laws. 2. To the extent required by law all work shall be performed by individuals duly licensed and authorized by law to perform said work. 3. Contractor may at its discretion engage subcontractors to perform work hereunder, provided Contractor shall fully pay said subcontractor and in all instances remain responsible for the proper completion of this Contract. 4. Contractor shall furnish Homeowner appropriate releases or waivers of lien for all work performed or materials provided at the time the next periodic payment shall be due. 5. All change orders shall be in writing and signed by both Homeowner and Contractor. The cost for mutually agreed to additional work, required due to unknown conditions or substantive change orders,will based on the current bill rates for the actual time used.Additional materials will be billed at contractor cost.All change orders subject to 10% markup for overhead. p ^`, Copyright TMK Remodeling 2014 Initials All Rights Reserved Page 1 TMK Remodeling 214 Sutton Hill Rd Contract CSL 105086 North Andover MA 01845 88_Mablin_Window R2 HIC 165887 978 852-4491 RRP LR000106 www.tmkremodeling.com 6. Contractor warrants it is adequately insured for injury to its employees and others incurring loss or injury as a result of the acts of Contractor or its employees and subcontractors. 7. Contractor shall at its own expense obtain all permits necessary for the work to be performed. 8. Contractor agrees to place all debris in an on-site trash receptacle(dumpster) and leave the premises in broom clean condition. 9. In the event Homeowner shall fail to pay any periodic or installment payment due hereunder, Contractor may cease work without breach pending payment or resolution of any dispute. 10.The Contractor and the Homeowner hereby mutually agree in advance that in the event that the Contractor has a dispute concerning this contract,the Contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the Homeowner shall be required to submit to such arbitration as provided in MGL c 142A. Homeowne Date: /- _ . .. J Contra or Date: Notice: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the Contractor. The Homeowner may initiate alternative dispute resolution even where this section is not signed by the parties. 11. Contractor shall not be liable for any delay due to circumstances beyond its control including strikes, casualty or general unavailability of materials,or inclement weather. 12. Contractor warrants all work for a period of 12 months following completion. 13. Contractor may post small signage(18x24")on property advertising services during the duration of the project. 14. The Contractor and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Boston, MA 02116 Phone: (617)973-8700 15. The Contractor or Homeowner may terminate this contract at any time for any reason by giving 3 days notice in writing to the other party. If either party terminates the contract as provided herein,then the contractor will be paid for work(labor and materials)completed as of the date of termination plus any materials or equipment that are backordered and not delivered. Payment is defined as actual job costs for the project plus 10%overhead charge. The contractor will provide a written report detailing actual job costs plus overhead for payment. The Contractor will refund any funds paid by the Homeowner that are a remaining balance for the labor and materials used as of the date of termination, plus any materials or equipment that are backordered and not delivered, plus 10%overhead charge. The Contractor will make arrangements for the backordered items to be delivered to the Homeowner. Copyright TMK Remodeling 2014 Initials' All Rights Reserved Page 2 TMK Remodeling 214 Sutton Hill Rd Contract CSL 105086 North Andover MA 01845 88_Mablin_Window_R2 HIC 165887 978 852-4491 RRP LR000106 www.tmkremodeling.com 16. The Homeowner is responsible for maintaining adequate access to the property including snow removal, personal property storage,and working doorways, stairways and walkways. In the event the contractor is required to provide access or repair to the doorways, stairways and walkways,then the Contractor will bill the Homeowner at the hourly bill rate for same. ARTICLE 6.OTHER TERMS ARTICLE 7.ACCEPTANCE Signed this O��day of 20 Homeown _.. . C tractor NOTICE: The signatures of t±iespply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The Homeowner may initiate alternative dispute resolution even where this section is not signed separately by the parties. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Copyright TMK Remodeling 2014 Initials All Rights Reserved Page 3 Licenses: TMK Remodeling Exhibit A-Statement of Work CSL 105086 214 Sutton Hill Rd 88_Mablin_Window R2 HIC 165887 North Andover MA 01845 RRP LR000106 978 852-4491 www.tmkremodeling.com 1 Owner: A B C E F G 2 James McDonough Estimate: 2015-028 Estimate valid for 30 days 3 iamesimcd(ct cs.com Date: 06/14/15 Expires: 07/14/15 4 88 Mablin St 5 North Andover MA 01845 6 978 973-3497 7 8 Scope of Work Remove existing 96x60"bay window.Prepare rough opening and install new Harvey vinyl bay window as shown on attached specification.Trim interior and exterior to match 9 existing. 10 Notes: 11 Pricing includes labor and materials to install finished item+allowances. EA=Each 12 EA Total Cost 13 Quantity Cost 14 1.0 Administration 6 $942 $942 15 01 Plans and Permits1:01.2 Building Permits i $44 $44 16 Building Permit 1 $44 $44 17 02 Site Work 3 $303 $303 18 Adjacent spaces to be protected by temporary barriers from dust infiltration 1 $132 $132 19 All floor coverings and hand rails between the work area and primary entrance to be covered with protective covering material 1 $171 $171 20 Owner responsible for storing any items to re-installed 1 $0 $0 21 02 Site Work:02.10 Demo 1 $250 $250 22 Disposal of debris and scrap materials 1 $250 $250 23 31 Overhead&Expenses 1 $345 $345 24 Overhead and project administration 1 $345- $345 25 1st Fir Bay Window Replacement 8x5' $2,798 $2,798 26 02 Site Work02.10 Demo 1 $105 $105 27 Remove existing door/window and frame 1 $105 $105 LM 13 Windows,&Trim 9 $2,694 §2,694. 29 Furnish&install 96x60 Harvey Vinyl Bay Window,frame,trim,weather stripped,flashed painted _.__ 1 $2,694 $2 694 30 Grand Total` 8 $3,740 $3,740 ©Copyright TMK Remodeling All Rights Reserved Page-4 Unlawful to distribute without permission 1��- The Commonwealth ofMasstachusetts Department of IndustrialAccidents a. 1 Congress Street,Suite 100 Boston,MA. 02114-2017 SJ*V� www mass,govldia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeObly NaMe(Business/Organization/ludividual): P('Y„)ell tr .Address: 2-1 `U'2. Cwt �� " City/State/Zip: " "'".. Phone#: � Are you an employer?Check tEe appropriate box: 'Type of project(x'equired): I am a employer with .� employees(full and/or part-time).* 7. ❑New construction I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] • 9. El Demolition 3.❑I am a homeowner doing all work myseI£[No workers'comp.insurance required.]t 10 [❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13. Roof repairs These sub-contractors have employees and have workers'comp.insruance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.El Other 152,§1(4),and we have na employees.[No workers'comp.insurance required.] IL *Any applicant that checks box4l must also fill out the section below showingtheir workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must-attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-conlracfors have employees,Vhey most provide their workeis'comp.policy number. I am an employer that ispi oviding workers'compensation insurance far my employees.•Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: �� � �� Exp]rationDate: fob Site Address: ° d &e /' ' 1 Ao d vVL bio/` city/state/zip- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date), i Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a Eno of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA,for insurance coverage verification. I do hereby certify u#er t ie pains and penalt'sof e ury that the information provided alcove is true and correct. Sr nature: Date; Phone " Official use only. Do not write in this area,to he completed by city or town official.. City or Town: Permit/License# Issuing Authority'(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5•Plumbing Inspector 6.Other Contact Person: Phone#: OP ID,J( CERTIFICATE OF LIABILITY INSURANCE [:!F(MNVDDNYYY) 07/28/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSVRER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATP-HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and condltlons of the policy,certain policies may require an endorsement. A statement on this Certificate does not confer rights to the cartlflcate holder In lieu of such endorsement(s). PRODUCER 978-975-1300 CONTACT NAME: Segrev�&Hall Insur.Assoc.lnc 978_875-7596 PHONE(AIo E e: FAX 305 North Main 5t. E-MAIL Andover,MA 01810 ADDRESS: Lawrence J.Hall PRODUCER TIIMKRE-1 CUSTO INSURERS AFFORDING COVERAGE NAIC 0 INSURED TMKRemodeling INSURERA:Arbella Protection Ins.Co- 41360 214 Sutton Hill Rd INsuasRs:AEIC 11104 North Andover,MA 01845 INSURER C t INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR TYPE OF INSURANCE A POLICY NUMBER MNWDIYYYY MM/DDNYYY LIMITS G@NERAL LIABILITY EACHOCCURRENC6 $ 1,000,0( DAMAG6 TO REN A X COMMERCIAL GENERAL.LIABILITY PREMIS a occurrence) $ 100,0( CLAIMS-MADE F�OCCUR MED EXP(Any one person $ 5,0( 9520037133 03/08/15 03/08/16 PERSONAL&ADV INJURY $ 1100010( GENERALAGGREGATE $ 2,000,0( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,0( POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Par peraon) $ ALI,OWNED AUTOS BODILY INJURY(Per ece'dent) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Peraccldent) $ NON-OWNED AUTOS $ UMBRELLALIABOCCUR EACH OCCURRENCE $ EXCESS LIAB HOLAIMS-MADE AGGREOATE $ DEDUCTIBLE $ RETENTION $ WORKeRS COMPENSATION WC STATU- 0TH- AND EMPLOYERS'LIABILITY T `/LIMI" B ANY PROPRIETOR/PARTNER/EXECUTIVE Ya NfA E.L.EACHACCIDENT $ OM ICE oNdary n ER EXCLUDED? 5005011872 04/01/16 04/01/16 E.L.DISEASE-EA EMPLOYEE $ Ifyas dascribeunder DEBGtRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks 8ohedule,if more apace Is requirod) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS, 1600 Osgood Street North Andover,MA 01845 AUTHORIZED REPRESENTATIVE Lawrence J.Hall m 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD 10 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License; CS-105086 THEODORE M KELLEY 214 SUTTON HILL NORTH ANDOVER01845 ' I �� S lvw Expiration commissioner 10/08/2015 I ��e iPamr��ec�zcaercll�a�C�/l��c<t1¢c�cr�eCt Mee of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR gistration: 16588 DBA 7 /expiration: 415/2OT6.' Type: TMK REMODELING THEODORE KELLEY 214 SUTTON HILL RD. NORTHANDOVER,MA 01845 t Undersecretary f License or registration valid for individul use only before the expiration date. If found return to: ulation Office of Consumer Affairs and Business Reg 10 Park Plaza-Suite 5170 Boston,MA 02116 7� 11Z f �/? Not valid`VI bout signature